The International Civil Aviation Organization (ICAO) is currently “co-ordinating closely” with the World Health Organization (WHO) on the “potential implications for air connectivity” as a result of the Ebola virus outbreak in Sierra Leone, Liberia and Guinea.
The WHO, ICAO and IATA have considered passenger screening revisions to the WHO document on travel and transport in light of the outbreak and such action is still being reviewed by the WHO, which was also intending to seek inputs from the World Tourism Organization and Airports Council International (ACI).
Here in Canada, the Public Health Agency of Canada (PHAC) has recommended that Canadians avoid all non-essential travel to Guinea, Liberia and Sierra Leone due to the ongoing Ebola virus outbreak.
PHAC’s recommendation is designed to protect Canadian travellers and make it easier for health officials in these countries to dedicate their resources towards controlling the outbreak. Although the risk remains low, travellers could face difficulties accessing health care services from an increasingly burdened health care system.
As well, travellers could also be exposed to the Ebola virus when seeking medical care in a health care setting. Canada is not alone in making this recommendation; several other countries are also recommending against non-essential travel to the affected countries.
The health agency noted that Guinea, Liberia and Sierra Leone continue to report cases of Ebola virus disease (formerly known as Ebola haemorrhagic fever) and related deaths. Additional cases can be expected.
ICAO indicated that it remains in contact with the WHO on potential efforts which may be required to facilitate repatriation flights, as well as matters relating to air ambulance services in the affected areas.
IATA noted in its comments on the situation that the WHO’s current risk assessment for travel and transport is not recommending any travel restrictions or the closure of borders at points of entry. Further, IATA said that the WHO states, “The risk of a tourist or businessman/woman becoming infected with Ebola virus during a visit to the affected areas and developing disease after returning is extremely low, even if the visit included travel to the local areas from which primary cases have been reported. Transmission requires direct contact with blood, secretions, organs or other body fluids of infected living or dead persons or animal, all unlikely exposures for the average traveller. Tourists are in any event advised to avoid all such contacts.”
Similarly, WHO advises that transmission of the Ebola virus only occurs when patients are displaying symptoms of the disease which are severe. Symptoms of Ebola include fever, intense weakness, muscle pain, headache and sore throat; followed by vomiting, diarrhea, rash, impaired kidney and liver function, and at advanced stage, both internal and external bleeding. It is highly unlikely that someone suffering such symptoms would feel well enough to travel.
In the rare event that a person infected with the Ebola virus was unknowingly transported by air, WHO advises that the risks to other passengers are low. None-the-less, WHO does advise public health authorities to carry out contact tracing in such instances.
In line with WHO guidance, awareness-raising activities initiatives are being conducted for travellers to and from the affected region. As always, passengers are advised not to travel if they are unwell. And any traveller developing symptoms of the Ebola within three weeks of returning from an affected region is advised to seek rapid medical attention.
The air transport industry has dealt with several outbreaks of communicable diseases in recent years. The global response to communicable diseases is governed by the WHO’s International Health Regulations. Airlines follow guidance material which has been developed by WHO, ICAO and IATA.
IATA will continue to monitor developments closely in the Ebola outbreak in close co-ordination with the WHO and ICAO.